Restarting statins in a specialist lipid clinic setting

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main source(s): Health Research Board. Background Statin therapy remains a gold standard in the primary and secondary prevention cardiovascular disease (CVD).[1] Poor statin compliance discontinuation due to intolerance (SI) pervasive clinical issue.[1] has demonstrated that prevalence SI is overestimated with most symptoms being nocebo.[2-3] Our practice involves patient centred intervention restart statins four components: 1) careful exclusion differential diagnoses 2) an in-person discussion regarding based on contemporary evidence 3) incremental introduction starting at lowest dose 4) virtual follow up ensure implementation therapeutic plan. The aim this study was assess effectiveness terms reintroduction subsequent cholesterol levels. Methods An ethically approved retrospective chart review performed consecutive adult patients attending specialist lipid clinic over six-month period 2021. Patient data recorded included demographics, characteristics, treatment received biochemical profiles. Statistical analysis using Student T-test. Results This 370 patients. 25% 10% referred explicitly for SI. Patients were predominantly female (71%). Statin-associated muscle common (62%). restarted 48% [Rosuvastatin: (62%), Simvastatin: (16%), Atorvastatin: (13%), Pravastatin: (9%)]. Restarting significantly improved mean reductions both total (TC) (P = 0.007) low-density lipoprotein C (LDL-C) (P< 0.001) levels versus management or without alternative lipid-lowering agents [primarily ezetimibe (30%)]. restart: (TC reduction: 3.17 ± 2.27 mmol/L, LDL-C 2.93 1.77 mmol/L). Management agents: [TC 1.61 1.46 LDL-C: 1.35 0.93 mmol/L]. Conclusion highlights among clinic. Statins successfully half presenting cases conferred significant improvement TC compared agents. Interventions are warranted given high nocebo effect undoubted benefits treatment. Ideally such interventions should be replicated care setting.